The National Health Education Standards 1995, 2004

Introduction

National Health Education Standards: Achieving Health Literacy (1995) from the Joint Committee on National Health Education Standards; Benchmarks for Science Literacy (1993) from Project 2061, American Association for the Advancement of Science; Health Framework for California Public Schools from the California Department of Education (1994); the Report of the 1990 Joint Committee on Health Education Terminology, from JCHET (1990); the Michigan Essential Goals/Objectives for Health Education (1988) from the Michigan State Board of Education; and the National Science Education Standards (1996) from the National Research Council.

The National Health Education Standards (NHES) were developed to establish, promote and support health-enhancing behaviors for students in all grade levels—from pre-Kindergarten through grade 12. The NHES provide a framework for teachers, administrators, and policy makers in designing or selecting curricula, allocating instructional resources, and assessing student achievement and progress. Importantly, the standards provide students, families and communities with concrete expectations for health education.

First published in 1995, the NHES were created in response to several model standards being developed for other areas of education by educational leaders across the United States in the early 1990's. With support from the American Cancer Society, the Joint Committee on National Health Education Standards was formed to develop the standards. Committee members included:

American Association for Health Education

American Public Health Association

American School Health Association

The Society of State Leaders of Health and Physical Education

Over the last decade, the NHES became an accepted reference on health education, providing a framework for the adoption of standards by most states. A review process begun in 2004 resulted in revisions to the NHES that acknowledged the impact and strength of the original document and took into account more than 10 years of use nationwide. The 2nd edition National Health Education Standards—Achieving Excellence promises to reinforce the positive growth of health education and to challenge schools and communities to continue efforts toward excellence in health education.

Standards and Performance Indicators

The NHES are written expectations for what students should know and be able to do by grades 2, 5, 8, and 12 to promote personal, family, and community health. The standards provide a framework for curriculum development and selection, instruction, and student assessment in health education.

Standard 1

Students will comprehend concepts related to health promotion and disease prevention to enhance health.

Rationale: The acquisition of basic health concepts and functional health knowledge provides a foundation for promoting health-enhancing behaviors among youth. This standard includes essential concepts that are based on established health behavior theories and models. Concepts that focus on both health promotion and risk reduction are included in the performance indicators.

Grades 3-5
1.5.1
Describe the relationship between healthy behaviors and personal health.
1.5.2
Identify examples of emotional, intellectual, physical, and social health.
1.5.3
Describe ways in which safe and healthy school and community environments can promote personal health.
1.5.4
Describe ways to prevent common childhood injuries and health problems.
1.5.5
Describe when it is important to seek health care.

Grades 6-8
1.8.1
Analyze the relationship between healthy behaviors and personal health.
1.8.2
Describe the interrelationships of emotional, intellectual, physical, and social health in adolescence.
1.8.3
Analyze how the environment affects personal health.
1.8.4
Describe how family history can affect personal health.
1.8.5
Describe ways to reduce or prevent injuries and other adolescent health problems.
1.8.6
Explain how appropriate health care can promote personal health.
1.8.7
Describe the benefits of and barriers to practicing healthy behaviors.
1.8.8
Examine the likelihood of injury or illness if engaging in unhealthy behaviors.
1.8.9
Examine the potential seriousness of injury or illness if engaging in unhealthy behaviors.

Grades 9-12
1.12.1
Predict how healthy behaviors can affect health status.
1.12.2
Describe the interrelationships of emotional, intellectual, physical, and social health.
1.12.3
Analyze how environment and personal health are interrelated.
1.12.4
Analyze how genetics and family history can impact personal health.
1.12.5
Propose ways to reduce or prevent injuries and health problems.
1.12.6
Analyze the relationship between access to health care and health status.
1.12.7
Compare and contrast the benefits of and barriers to practicing a variety of healthy behaviors.
1.12.8
Analyze personal susceptibility to injury, illness, or death if engaging in unhealthy behaviors.
1.12.9
Analyze the potential severity of injury or illness if engaging in unhealthy behaviors.

Standard 2

Students will analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors.

Rationale: Health is affected by a variety of positive and negative influences within society. This standard focuses on identifying and understanding the diverse internal and external factors that influence health practices and behaviors among youth, including personal values, beliefs, and perceived norms.

Performance Indicators*

Pre-K-Grade 2
2.2.1
Identify how the family influences personal health practices and behaviors.
2.2.2
Identify what the school can do to support personal health practices and behaviors.
2.2.3
Describe how the media can influence health behaviors.

Grades 3-5
2.5.1
Describe how family influences personal health practices and behaviors.
2.5.2
Identify the influence of culture on health practices and behaviors.
2.5.3
Identify how peers can influence healthy and unhealthy behaviors
2.5.4
Describe how the school and community can support personal health practices and behaviors.
2.5.5
Explain how media influences thoughts, feelings, and health behaviors.
2.5.6
Describe ways that technology can influence personal health.

Grades 6-8
2.8.1
Examine how the family influences the health of adolescents.
2.8.2
Describe the influence of culture on health beliefs, practices, and behaviors.
2.8.3
Describe how peers influence healthy and unhealthy behaviors.
2.8.4
Analyze how the school and community can affect personal health practices and behaviors.
2.8.5
Analyze how messages from media influence health behaviors.
2.8.6
Analyze the influence of technology on personal and family health.
2.8.7
Explain how the perceptions of norms influence healthy and unhealthy behaviors.
2.8.8
Explain the influence of personal values and beliefs on individual health practices and behaviors.
2.8.9
Describe how some health risk behaviors can influence the likelihood of engaging in unhealthy behaviors.
2.8.10
Explain how school and public health policies can influence health promotion and disease prevention.

Grades 9-12
2.12.1
Analyze how the family influences the health of individuals.
2.12.2
Analyze how the culture supports and challenges health beliefs, practices, and behaviors.
2.12.3
Analyze how peers influence healthy and unhealthy behaviors.
2.12.4
Evaluate how the school and community can affect personal health practice and behaviors.
2.12.5
Evaluate the effect of media on personal and family health.
2.12.6
Evaluate the impact of technology on personal, family, and community health.
2.12.7
Analyze how the perceptions of norms influence healthy and unhealthy behaviors.
2.12.8
Analyze the influence of personal values and beliefs on individual health practices and behaviors.
2.12.9
Analyze how some health risk behaviors can influence the likelihood of engaging in unhealthy behaviors.
2.12.10
Analyze how public health policies and government regulations can influence health promotion and disease prevention.

Standard 3

Students will demonstrate the ability to access valid information, products, and services to enhance health.

Rationale: Access to valid health information and health-promoting products and services is critical in the prevention, early detection, and treatment of health problems. This standard focuses on how to identify and access valid health resources and to reject unproven sources. Application of the skills of analysis, comparison, and evaluation of health resources empowers students to achieve health literacy.
Performance Indicators*

Pre-K-Grade 2
3.2.1
Identify trusted adults and professionals who can help promote health.
3.2.2
Identify ways to locate school and community health helpers.

Grades 9-12
3.12.1
Evaluate the validity of health information, products, and services.
3.12.2
Use resources from home, school, and community that provide valid health information.
3.12.3
Determine the accessibility of products and services that enhance health.
3.12.4
Determine when professional health services may be required.
3.12.5
Access valid and reliable health products and services.

Standard 4

Students will demonstrate the ability to use interpersonal communication skills to enhance health and avoid or reduce health risks.

Rationale: Effective communication enhances personal, family, and community health. This standard focuses on how responsible individuals use verbal and non-verbal skills to develop and maintain healthy personal relationships. The ability to organize and to convey information and feelings is the basis for strengthening interpersonal interactions and reducing or avoiding conflict.

Grades 9-12
4.12.1
Use skills for communicating effectively with family, peers, and others to enhance health.
4.12.2
Demonstrate refusal, negotiation, and collaboration skills to enhance health and avoid or reduce health risks.
4.12.3
Demonstrate strategies to prevent, manage, or resolve interpersonal conflicts without harming self or others.
4.12.4
Demonstrate how to ask for and offer assistance to enhance the health of self and others.

Standard 5

Students will demonstrate the ability to use decision-making skills to enhance health.

Rationale: Decision-making skills are needed to identify, implement, and sustain health-enhancing behaviors. This standard includes the essential steps that are needed to make healthy decisions as prescribed in the performance indicators. When applied to health issues, the decision-making process enables individuals to collaborate with others to improve their quality of life.

Performance Indicators*

Pre-K-Grade 2
5.2.1
Identify situations when a health-related decision is needed.
5.2.2
Differentiate between situations when a health-related decision can be made individually or when assistance is needed.

Grades 3-5
5.5.1
Identify health-related situations that might require a thoughtful decision.
5.5.2
Analyze when assistance is needed in making a health-related decision.
5.5.3
List healthy options to health-related issues or problems.
5.5.4
Predict the potential outcomes of each option when making a health-related decision.
5.5.5
Choose a healthy option when making a decision.
5.5.6
Describe the outcomes of a health-related decision.

Grades 6-8
5.8.1
Identify circumstances that can help or hinder healthy decision making.
5.8.2
Determine when health-related situations require the application of a thoughtful decision-making process.
5.8.3
Distinguish when individual or collaborative decision making is appropriate.
5.8.4
Distinguish between healthy and unhealthy alternatives to health-related issues or problems.
5.8.5
Predict the potential short-term impact of each alternative on self and others.
5.8.6
Choose healthy alternatives over unhealthy alternatives when making a decision.
5.8.7
Analyze the outcomes of a health-related decision.

Grades 9-12
5.12.1
Examine barriers that can hinder healthy decision making.
5.12.2
Determine the value of applying a thoughtful decision-making process in health-related situations.
5.12.3
Justify when individual or collaborative decision making is appropriate.
5.12.4
Generate alternatives to health-related issues or problems.
5.12.5
Predict the potential short-term and long-term impact of each alternative on self and others.
5.12.6
Defend the healthy choice when making decisions.
5.12.7
Evaluate the effectiveness of health-related decisions.

Standard 6

Students will demonstrate the ability to use goal-setting skills to enhance health.

Rationale: Goal-setting skills are essential to help students identify, adopt, and maintain healthy behaviors. This standard includes the critical steps that are needed to achieve both short-term and long-term health goals. These skills make it possible for individuals to have aspirations and plans for the future.

Performance Indicators*

Pre-K-Grade 2
6.2.1
Identify a short-term personal health goal and take action toward achieving the goal.
6.2.2
Identify who can help when assistance is needed to achieve a personal health goal.

Standard 7

Students will demonstrate the ability to practice health-enhancing behaviors and avoid or reduce health risks.

Rationale: Research confirms that practicing health-enhancing behaviors can contribute to a positive quality of life. In addition, many diseases and injuries can be prevented by reducing harmful and risk-taking behaviors. This standard promotes the acceptance of personal responsibility for health and encourages the practice of healthy behaviors.

Grades 6-8
7.8.1
Explain the importance of assuming responsibility for personal health behaviors.
7.8.2
Demonstrate healthy practices and behaviors that will maintain or improve the health of self and others.
7.8.3
Demonstrate behaviors to avoid or reduce health risks to self and others.

Grades 9-12
7.12.1
Analyze the role of individual responsibility for enhancing health.
7.12.2
Demonstrate a variety of healthy practices and behaviors that will maintain or improve the health of self and others.
7.12.3
Demonstrate a variety of behaviors to avoid or reduce health risks to self and others.

Standard 8

Students will demonstrate the ability to advocate for personal, family, and community health.

Rationale: Advocacy skills help students promote healthy norms and healthy behaviors. This standard helps students develop important skills to target their health-enhancing messages and to encourage others to adopt healthy behaviors.

Grades 6-8
8.8.1
State a health-enhancing position on a topic and support it with accurate information.
8.8.2
Demonstrate how to influence and support others to make positive health choices.
8.8.3
Work cooperatively to advocate for healthy individuals, families, and schools.
8.8.4
Identify ways in which health messages and communication techniques can be altered for different audiences.

Grades 9-12
8.12.1
Utilize accurate peer and societal norms to formulate a health-enhancing message.
8.12.2
Demonstrate how to influence and support others to make positive health choices.
8.12.3
Work cooperatively as an advocate for improving personal, family, and community health.
8.12.4
Adapt health messages and communication techniques to a specific target audience.

Standard 2. Understands the history and trends of health care, both past and present
1. Knows how a specific health care service has evolved through time (e.g., changes in processes and procedures unique to that service)
2. Knows milestones that have changed health care (e.g., technology, sterilization, vaccines, antibiotics, third party payer systems)
3. Knows features of the various health care delivery systems that have evolved, the services provided, and the clients served by each
4. Knows how roles of health care workers have changed
5. Understands the origins of medicine, including folklore, herbs, and quackery
6. Knows various health care providers (e.g., HMO, PPO, managed care) in terms of the services provided, strengths, weaknesses, costs, availability, co-payment, and disbursement system

Standard 3. Understands the distinctions among the various levels of care
1. Knows various departments in an acute care hospital (e.g., intensive care, cardiac care, pediatrics) and describe the typical patient population and practices that occur in the department
2. Knows the kinds of care that should be provided and the level of recovery anticipated for various injuries
3. Knows treatments and procedures necessary in the care of the developmentally disabled
4. Knows basic skills and appropriate responses for various emergency encounters
5. Knows various forms of therapy (e.g., physical, respiratory) used for rehabilitating patients

Standard 4. Understands how technology is used in the health-care industry
1. Knows forms of technology used in the four health occupations systems (i.e., therapeutic, diagnostic, informational, and environmental systems)
2. Understands ways in which technology is used in the health care industry (e.g., use of computer technology for collecting data and retrieving, documenting, and charting information; use of technologies such as MRI, CAT scans, and sonography)
3. Understands ways in which technology has changed health care
4. Understands how improvements in technology have affected patient diagnosis (e.g., electronic blood pressure and temperature, specimen testing, noninvasive explorations, imaging equipment and techniques)
5. Knows scientific discoveries and breakthroughs that have been made in the field of health care
6. Understands the costs, benefits, and disadvantages of advanced health care technology (e.g., organ transplants, neo-natal procedures, ventilators)

Systems

Standard 5. Understands the components of the health care delivery system
Level IV (Grade 9-12)
1. Knows the service areas in health care (e.g., therapeutic, diagnostic, informational, environmental)
2. Knows various processes that affect health care delivery (e.g., integrated systems, alternative care, reimbursement, cost systems)
3. Understands ways in which the settings of health care delivery systems have changed over time (e.g., long-term care settings, outpatient clinics, patients’ home)
4. Understands how the evolution of health care practices, procedures, and philosophies has influenced the role of health care delivery systems in a variety of areas (e.g., disease prevention, health maintenance, diagnosis, treatment, and rehabilitation)
5. Understands the role of the government in the health care system (e.g., health care legislation, regulations and subsidies in the health welfare field)
6. Understands the roles and responsibilities of various members of health care systems and how they contribute to the function of the system (e.g., knows daily schedules of other workers, knows own role in performing one’s job; knows details of other jobs)
7. Knows relevant systems in the health care facility and how they function (e.g., how a hospital’s social service department functions in order to answer patient questions)
8. Knows uses for resources within and outside the health care facility (e.g., staff, manuals, training opportunities; patient services offered by resources outside the health care facility)

Standard 6. Understands the role of continuous improvement and efficiency in the health care industry
1. Understands factors that influence the quality of health care services (e.g., health care needs, funding, staffing, regulation of practice )
2. Understands the roles and responsibilities of individual members in a health care team and how they influence the delivery of quality health care
3. Knows strategies for improving delivery of service to clients in the health care industry (e.g., keeping up with changes in the organization; collecting patient suggestions, performing quality control procedures to monitor functions in various areas of the health care facility such as the laboratory)
4. Knows activities and techniques that contribute to efficiency in health care facilities (e.g., containing costs, reducing waste, recycling and waste management)
5. Knows types of staff development that contribute to the improvement of health care services (e.g., on-the-job training for entry-level staff; on-going training, including workshops, conferences, course work, and professional associations)
6. Knows measures used to control costs in health care (e.g., Diagnosis Related Groups (DRGs) for classification and regulation of government reimbursements to hospitals; prospective payment systems to specify fixed reimbursement levels to hospitals for various procedures)
Standard 7. Understands the relationship between the health care delivery system and the community
1. Knows characteristics of different health care providers (e.g., strengths, weaknesses, costs, availability, co-payment and reimbursement systems of health maintenance organizations (HMO), preferred provider organizations (PPO), hospice managed care, etc)
2. Knows debates concerning current and proposed national health care policies (e.g., Medicare, Medicaid, insurance pharmaceutical issues)
3. Knows current factors that have influenced the supply of health care personnel (e.g., decrease in young entry-level workers in health care, increase in employment opportunities for women, the high cost of allied health and nursing programs)
4. Knows ways in which social, political, and economic factors affect health care delivery in a health care agency (e.g., the impact of the aging population, expanding immigrant populations, the impact of the free enterprise system)

Client Movement

Standard 8. Understands the principles of body mechanics for positioning, transferring, and transporting clients
1. Knows methods for positioning client to ensure comfort
2. Knows methods for safely transporting ill or injured people (e.g., chair carry, fore and aft carry, four-handed seat carry, blanket carry, use of stretchers)
3. Understands how center of gravity and base of support play in part in proper lifting techniques (e.g., how forces affect movement; how the muscles, bones, and joints work together to produce movement)
4. Understands the effects of movement, torque, tension, and elasticity on the human body
5. Knows various transport and transfer equipment and their appropriate use (e.g., wheelchairs, gurneys)
6. Understands that it is important to reassure and inform clients of what to expect during an activity

Health Maintenance Practices

Standard 9. Knows techniques to prevent the spread of illness and disease
1. Knows the body’s natural defense systems against infection such as barriers, the inflammatory response, and the immune response
2. Knows common infectious diseases present at school or home and details of the diseases (e.g., signs and symptoms, means of transmission, causative microorganism, recommendations to prevent the spread of the diseases)
3. Knows that the spread of pathogens can be prevented by cleaning, disinfecting, or sterilizing

Standard 10. Knows conventional and alternative methods to promote and maintain personal health
1. Knows a variety of cultural beliefs and traditional and nontraditional approaches to health care for several cultures
2. Knows treatment plans in conventional western medicine for several patient conditions and how they differ from alternative treatments